Author + information
- Fabio Zampieri, PhD,
- Cristina Basso, MD, PhD and
- Gaetano Thiene, MD∗ ()
- ↵∗Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Via A. Gabelli, 61–35100 Padua, Italy
To the Editor:
The seal of the American College of Cardiology (ACC) reproduces the Vesalian heart from the Tabulae anatomicae sex (Venice, 1538) (1). First registered in January 1965, it was selected by Professor Franz Maximilian Groedel (1881 to 1951), who—after having been among the protagonists of the German Cardiac Society (2)—supported the foundation of the College in 1949 and wanted the ACC to have a “stamp of learning.” This seal has been used on all ACC publications, beginning with volume 1 of Transactions of the American College of Cardiology (1951) until the February 2002 issues of the Journal of the American College of Cardiology.
Groedel was familiar with De humani corporis fabrica libri septem (On the Fabric of the Human Body in 7 books), a textbook of human anatomy published by Andreas Vesalius (1514 to 1564) in 1543 (3), owning an original copy of it.
In those years, important studies on Vesalius were published in English, such as the translation of the Tabulae in 1946 (4) and the study on Vesalius by Charles O’Malley (1907 to 1970) in 1964 (5). Complete English translations of the Fabrica have been published only in the past 20 years, and a new one is going to be published in 2014.
When discussions about changing the seal of the College arose over 1 decade ago, Dr. Bruce Fye encouraged the preservation of the key components. The original Vesalian heart graphic used by the College included the Latin inscription “Cor Vitalis facultatis fomes et arte princ” (the heart is the source of vital spirit and the beginning of arteries), which has been removed in the contemporary version. The current ACC logo was registered in 1989 and started to be printed in the Journal from March 2002 (Fig. 1).
The choice of the logo of the ACC from the Vesalian Tabulae may be surprising. In this book, Vesalius seemed to be still a believer in the theories developed by the Greco-Roman physician Galen of Pergamon (AD 129 to 216). However, in his following publications, Vesalius made some fundamental steps forward in correcting his anatomic thoughts from the errors of Galen. This paper will give an account of this question for the occasion of the 500 years from the birth of the great anatomist (1514 to 2014).
Medieval and Renaissance medicine was almost totally based on the theories developed by Galen. According to him, the physiology of human body was based on 4 “humors”—blood, phlegm, black and yellow bile—and 3 spirits or “pneuma”—natural, vital, and animal. The blood system was divided in 2 compartments without a circular connection. The venous one with blood-natural spirit was produced by the liver and passed to the right ventricle through the vena cava; and the arterial one with blood-vital spirit produced in the left ventricle by the mixture of air coming from the lungs with the blood-natural spirit coming from the right to left ventricle through invisible pores in the interventricular septum. Finally, the arterial blood with vital spirit was filtered by a network of vessels—called “rete mirabile”—at the base of brain, supposed to exist in humans, where the animal spirit (the “soul”), responsible for cognitive functions, was produced. This spirit was then transmitted to the body by nerves.
Vesalius, born in Brussels, after having studied at Leuven and Paris, graduated in medicine at Padua University in 1537 and became professor of anatomy and surgery the following academic year. In 1538, Vesalius published the Tabulae anatomicae sex, from which the seal of the ACC is taken (Fig. 1). This publication was still based on Galenic ideas and errors. Vesalius defined the heart as the source of “vitalis facultate” (vital spirit) and the “arteria venalis” (pulmonary vein) as the structure that brings air from the lung to the left atrium and ventricle. In the picture of the heart, the letter “Q“—corresponding to the pulmonary vein—was described in the caption as the “Arteria venalis in sinistrum sinum aerem ex pulmonibus deferens” (pulmonary vein bringing air from lungs to left atrium) (1) (Fig. 1).
In his subsequent publications, however, Vesalius made probably the first step in discrediting Galenic physiology, on the basis of the idea of interventricular septum patency (6). Already in the first edition of De humani corporis fabrica, Vesalius seemed to be quite doubtful, claiming he was unable to see these hypothetic pores:
Thus we are compelled to astonishment at the industry of the Creator who causes the blood to sweat from the right ventricle into the left through passages which escape our sight (3).
Vesalius, in the second edition of his Fabrica (1555), clearly denied the existence of the pores:
However much the pits may be apparent, yet none, as far as can be comprehended by sense, passes through the septum of the heart from the right ventricle into the left. I have not seen even the most obscure passages by which the septum of the ventricles is pervious, although they are mentioned by professors of anatomy since they are convinced that blood is carried from the right ventricle to the left. As a result—as I shall declare more openly elsewhere—I am in no little doubt regarding the function of the heart in this part (7).
Given these fundamental changes in his mind the choice by the ACC to use as the seal an image from Vesalius’ Tabulae anatomicae sex was quite significant, because Vesalius made exactly the first step for the birth of modern cardiovascular physiology.
- American College of Cardiology Foundation
- ↵Vesalius A. Tabulae anatomicae sex. Venetiis, Italy: sumptibus Ioannis Stephani Calcarensis, 1538:III.
- Lüderitz B.,
- Holmes D.R.,
- Harold J.
- ↵Vesalius A. De humani corporis fabrica libri septem. Basileae, Switzerland: ex officina Ioannis Oporini, 1543:589.
- Singer C.,
- Rabin C.
- O’Malley C.
- Pagel W.
- ↵Vesalius A. De humani corporis fabrica libri septem. Basileae, Switzerland: Per Iannem Oporinum, 1555:734.